COVID-19: Projecting the impact in Rohingya refugee camps and beyond

Shaun A Truelove; Orit Abrahim; Chiara Altare; Andrew Azman; Paul B Spiegel

There are several limitations to this study. We are using a mass-action model, which tends to overestimate the size of outbreaks since populations are generally not closed and well mixed. However, due to population density and often closed nature of refugee camps, transmission in these settings has been shown to act more closely to theory. Additionally, the current evidence on the natural history and key epidemiological properties of COVID-19 reflect the interactions of the SARS-Cov-2 virus with nondisplaced populations. Population structure and population health can lead to widely different burden of disease with no modifications to the virus. With the particular demographic characteristics and health status of refugee populations, like this one in Cox's Bazaar, we need to be cautious when developing guidance based on previously estimated properties of SARS-CoV-2/COVID-19. Clinical surveillance, laboratory confirmation, and documentation are key to generating new evidence specific to this population and potentially generalizable to other refugee settings. Thus, we used the existing data that were available from documents and personal communications.